Chronic back pain can often be treated without surgery. Interventional pain medicine offers a number of alternatives to surgery that are designed to help you overcome chronic back pain and live a fuller life.
Acute pain can lead to chronic pain when it is left untreated. Chronic pain disables more people than cancer or heart disease, and can reduce your enjoyment of hobbies, prevent you from working, and even cause depression. Fortunately, effective treatments for chronic back pain are available, and surgery is not always required.
Interventional pain medicine focuses on building a regimen of treatment that is non-invasive and designed to improve your physical and mental well-being.
A facet injection has two primary objectives: diagnosis and pain relief.
The diagnostic goal of a facet injection is to determine if pain is coming from the facet joints in your spine. During the procedure, a numbing medication is injected into the facet joints of the spine. If your facet joints are the source of your pain, relief should be immediate. This relief may be temporary or long-term depending on the level of degeneration in the facet joint.
The pain relief goal of the procedure is aided by adding a time-released steroid, such as cortisone, with a numbing agent. The steroid reduces inflammation in the facet joint and may provide longer-term pain relief than a numbing agent alone.
Facet injections are also sometimes called “facet blocks” because their intention is to block chronic back pain. If you experience relief from a facet injection but the pain returns shortly after, you may be a candidate for radiofrequency rhizotomy.
Radiofrequency rhizotomy (RF rhizotomy) is an escalated treatment, meaning that it works best for patients who have not responded to more conservative pain management treatments. The procedure targets back pain resulting from progressive degeneration within the facet joints of the spine.
The procedure works by using radiofrequency-generated heat to disable the pain-sensing nerves in your facet joints. It is important that your radiologist identifies the origin of your pain prior to an RF rhizotomy exam. Your doctor may order an MRI of the spine, a facet injection, or possibly a discography to ensure the correct nerves are targeted. Lumbar discography is an injection technique used to evaluate patients with back pain who have not responded to extensive conservative care regimens.
During an RF rhizotomy you will stay awake to provide important feedback to the radiologist. A thin needle electrode is injected next to the damaged facet joint. The radiologist will numb the nerve with anesthetic and then apply heat with the electrode needle. The heat cauterizes the nerve, which shuts down its communication with your brain.
Radiofrequency rhizotomy can also be repeated around the facet joint above and below the origin of your pain. This ensures that any secondary pain from less damaged nerves is also eliminated.
Lumbar Epidural Steroid Injection
If you have a problem with chronic lower back pain, a lumbar epidural steroid injection (LESI) may be the solution. LESI has been a staple in the treatment of lumbar and sciatic pain since the early 1950s. The procedure works by introducing interventional pain medicine in the form of steroids into the area surrounding the nerves of the lower back, thus reducing inflammation and relieving pain.
During an LESI procedure, the doctor will begin by numbing the skin with a local anesthetic. Then, he or she will inject steroids into the dura, the sac that contains nerve roots in the lower back. These injections relieve pain in approximately 50% of patients. When they are effective, they provide relief for anywhere from one week to a few months.
Lumbar epidural steroid injections are most effective when utilized as part of a comprehensive rehabilitation program. LESIs are often used to allow sufficient pain relief for you to complete a stretching and exercise routine. Patients who respond well to LESI treatment can have up to three injections in a one-year period.
Interventional pain management can help keep your acute pain from becoming debilitating chronic pain. The best way to determine which treatment method is best for you is to speak to a qualified physician.
Call us at (877) 918-7020 to schedule a pain management consultation with Arkansas Surgical Hospital. Our expert team of pain management physicians can help you develop a treatment plan to treat your chronic back pain.